readmissions in-person conference - njhasuccessful lung transplant at super star! ipf cured! fall...
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Presented by Karen Curtiss President, PartnerHealth Founder, CampaignZERO Author, Safe & Sound in the Hospital
Welcome!
Readmissions In-Person Conference New Jersey Hospital Association, 9/13/17
The Case for Family Engagement: How One Family’s Tragedies are Transformed to Tools
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+ For All of Us – This Work is Personal Why Partner with Families? How to Partner with Families to Prevent Readmissions Take the Bossy Pants Challenge
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+ Goal?
Empowered
And and
Jazzed!
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“ Bring someone with you.”
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To all the world, you are
just one person.
But to one person, you could mean
the world.
PartnerHealth©2017
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Who are Your Nearest and Dearest?
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Devastating Diagnosis Successful lung transplant at Super Star! IPF cured! Fall VAP MRSA C diff DVT PE MRSA… again C diff… again Stage 4 Bed Sore Family bedside 7 months On the job learning – too little, too late
Bill Aydt, married to Margaret, 51 years 6 children, 9 grandchildren
I Was a Care Partner for My Dad
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+ I Was my Father’s Care Partner… And I Failed.
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+ Next, I was a Care Partner for my husband, Sandy
PartnerHealth © 2017
“Routine” Bowel Resection Sepsis Emergency Surgery VRE Discharged with…
… an IV, … colostomy and … drains
No supplies No confidence High anxiety and…
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+ It’s Complicated
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+ Patients Forget 80% of What You Tell Them
* Numerous studies in the U.S and U.K.
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+ 3 out of 4 patients, age 64+, leave the hospital with an incorrect prescription or no understanding of their medication regimen.
Yale New Haven study by Dr. Leora Horwitz of patients aged 64+ with heart failure, acute coronary syndrome or pneumonia, December 2012.
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PartnerHealth © 2017
Stressed
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+ Too Many Round Trips!
PartnerHealth © 2017
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“We have trained, hired and rewarded people to be cowboys, but it is pit crews that we need – pit crews for patients.”
- Atul Gawande MD
PartnerHealth © 2017
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Your Pit Crew to Prevent Readmissions
No one is more patient- centered. No one knows
your patient better.
Informed and Activated Care Partners
PartnerHealth © 2017
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FAMILY ENGAGEMENT for PATIENT SAFETY
Endorse Inform Connect Activate
PartnerHealth © 2017
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+ The Safe & Sound Rubric: Your “Cliff Notes” for Training
Written
Share Plain Facts (6th Grade/Below Level)
Aural/Speaking/Conversation/
Friendly, empathetic expressions, tone, “down to earth”
Tactile/Doing
Provide simple to-do’s and tools
PartnerHealth©2017
Learning Style How to Activate
#1
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In Baby Steps
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+ Activation Progression: AKA Your Pit Crew Training Modules
Level 3
Level 4
Overwhelmed
Aware
Taking action
Maintaining behaviors, pushing further Level 2
Level 1
During Hospital Stay
Pre-Admission
Admission
Post-Discharge Recovery
PartnerHealth © 2017
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Family Engagement to Prevent Readmissions
Endorse Inform Connect Activate
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PartnerHealth © 2017
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+ Endorsement
1. Provide planning checklists for patients and families who have scheduled admissions
2. Conduct shift change huddles and bedside reporting
3. Have a dedicated person or functional area for attending to patient and family engagement
4. Have an active PFAC (Patient and Family Advisory Council)
5. Have at least one patient/family member sit on your hospital’s Board of Trustees with full voting rights and privileges
6. Provide information and tools to patients and families to prevent HACs and readmissions. (from HEN 2.0)
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Family Engagement to Prevent Readmissions
Endorse Inform Connect Activate
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PartnerHealth © 2017
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+ Translation Please!
Bed Sore
OMG, about to die!!
Infection, bad germs
???
Yellow
Drink more water
Main doctor (or…. a street drug?)
PartnerHealth © 2017
What You Say… What Everyone Else Says/Thinks
Decubitus Ulcer
Heart Failure
MRSA
Isolation precautions
Jaundice
Up fluids
PCP
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Get Addicted to Flesch-Kincaid!
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Care Partner Checklist Their Plan of Care for Home
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Lisa Meers • Husband, Robert, healthy
• Collapsed while playing golf – no warning
• Quintuple bypass surgery scheduled
• Arranged time off, set up bedroom
• In quiet surgical waiting room, looked over checklists: realized how frail Robert was -- PANIC!
• Called insurance: Nurse approved!
• Felt more comfortable asking questions
• Went back to work once Robert discharged
• No mishaps in recovery: knew what he needed and had nurse on the job!
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Family Engagement to Prevent Readmissions
Endorse Inform Connect Activate
PartnerHealth © 2017
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PartnerHealth © 2017
Quick Tips Instill Connection with Graphics
Use simple, modern fonts: e.g., Calibri, Helvetica Neue, Arial Avoid Times New Roman Use clean colors Avoid red and black Avoid boldface and underline Avoid 10-pt/lower font size Avoid ALL CAPS
PartnerHealth © 2017
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PartnerHealth © 2017
Give “air” to text
Avoid single space
Chunk text with benefit-headlines
o Use bullets when you can
Left justify text, avoid centering
Use icons, illustrations
Illustrate with videos!
PartnerHealth © 2017
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Same Information – 2 Ways to Deliver
PartnerHealth © 2017
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Family Engagement to Prevent Readmissions
Endorse Inform Connect Activate
PartnerHealth © 2017
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S a f e & S o u n d E n g a g e m e n t P r o c e s s Copyright to PartnerHealth, LLC, 2013
Start with an Invitation to Partner with You
• To-do’s for safety and preventing readmission (6th grade reading level)
• Reasons why (motivation) • Grace notes for connection (art,
heart, tone)
• Before admission, at admission, during stay: ideally all!
• Letter, email, posters
PartnerHealth © 2017
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PartnerHealth © 2017
Provide On-the-Job Learning & Skills to Take Home
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Encourage Recording – Especially at Discharge PartnerHealth © 2017 Leventhal, R. (2013). Discharged with a Recording: How Cullman Regional is Optimizing Readmissions Work.
Healthcare Informatics, 41(2), 41-42. Retrieved from http://www.healthcare-informatics.com/article/discharged-
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+ “Press Record”
PartnerHealth © 2017
From the Oliver Center for Patient Safety at UTMB
https://www.youtube.com/watch?v=SUIWc5BHbuo
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“Since my husband and I are both in our middle 80's, probably one of us will be in the hospital sometime. I carefully went through the checklists…these records would be very helpful!! It will bring comfort and peace .” - Joanne Cerling
PartnerHealth © 2017
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S a f e & S o u n d E n g a g e m e n t P r o c e s s Copyright to PartnerHealth, LLC, 2013
You’re Ready! Take the Bossypants Challenge
PartnerHealth © 2017
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+ Please Choose! What Will You Do Next?
1. Provide planning checklists for patients and families who have scheduled admissions
2. Conduct shift change huddles and bedside reporting
3. Have a dedicated person or functional area for attending to patient and family engagement
4. Have an active PFAC (Patient and Family Advisory Council)
5. Have at least one patient/family member sit on your hospital’s Board of Trustees with full voting rights and privileges
6. Provide information and tools to patients and families to prevent HACs and readmissions. (from HEN 2.0)
PartnerHealth © 2017
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PartnerHealth © 2017
To all the world, you are
just one person.
But to one person, you could mean
the world.
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Thank you for your time today.
It meant the world to me.
Karen Curtiss [email protected] PH: 847.208.607